As a result of the Dispersed Model of health care used in the U.S., the hospital structure resembles a diamond, with.

Question

Options

• AThe bulk of the hospitals in the middle, providing a wide range of secondary and tertiary services.
• BA small number of hospitals at the top, which lack specialized units.
• CThe bulk of the hospitals in the middle, which lack specialized units.
• DA small number of hospitals at the base, which provide highly super specialized referral services.

• A
  93% (25)
• C
  4% (1)
• D
  4% (1)

Explanation

Option A is correct because the U.S. Dispersed Model encourages hospitals to compete broadly rather than specialize narrowly, resulting in the majority of facilities offering a wide range of secondary and tertiary services - forming the wide "belly" of the diamond shape, with fewer hospitals at the top (super-specialized referral centers) and fewer at the base (small/rural facilities).

Why the distractors are wrong:

• B is wrong on two counts: a small number at the top is structurally correct, but those apex hospitals are the most specialized, not lacking specialization.
• C mischaracterizes the middle tier - the bulk of U.S. hospitals do have specialized units; that's precisely why they cluster in the middle rather than at the extremes.
• D reverses the pyramid logic - super-specialized referral services belong at the top of the diamond, not the base.

Memory tip: Picture an actual diamond - fat in the middle, pointed at both ends. In the U.S. Dispersed Model, most hospitals try to "do it all" to stay competitive, so they pack the wide middle. Contrast this with a Concentrated/pyramidal model where most hospitals are basic and only a few are complex.

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